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Management of psychiatric disorders in children and adolescents with atypical antipsychotics

A systematic review of published clinical trials

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Abstract

We aimed to provide a descriptive review of treatment studies of atypical antipsychotics in paediatric psychiatric disorders. A systematic review of the literature used Medline and EMBASE databases to identify clinical trials of atypical antipsychotics in children and adolescents between 1994 and 2006. Trials were limited to double-blind studies and open-label studies of ≥8 weeks duration that included ≥20 patients. Nineteen double-blind and 22 open-label studies were identified. Studies included use of clozapine, olanzapine, quetiapine, risperidone, and ziprasidone in the treatment of disruptive behavioural disorders (DBDs), pervasive developmental disorders (PDDs), tic disorder, psychotic disorders, and mania. These medications generally reduced the severity of a variety of psychiatric symptoms in children and adolescents. Less frequent adverse events included extrapyramidal symptoms, hyperglycaemia and diabetes, and endocrine effects. The review of published scientific data suggests that most of the atypical antipsychotics, excluding clozapine, have a favourable risk/benefit profile and effectively reduce disabling behaviours in paediatric psychiatric patients. While there is a body of evidence published of treatment of DBDs and PDDs, there is a lack of controlled data to guide clinical practice for the use of atypical antipsychotics for paediatric psychotic disorders and bipolar disorder. While there have been studies with duration up to 2 years, no definitive data are available that suggest long-term safety; additional studies are warranted.

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Authors and Affiliations

  1. Center for the Advancement of Children’s Mental Health, Columbia University New York State Psychiatric Institute, New York, NY, USA

    Peter S. Jensen

  2. Department of Psychiatry, and Karakter, University Center for Child and Adolescent Psychiatry Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands

    Jan Buitelaar

  3. Janssen Pharmaceutica Inc., 1125 Trenton-Harbourton Rd, Titusville, NJ, 08560, USA

    Gahan J. Pandina

  4. Janssen-Ortho Inc., Toronto, Canada

    Carin Binder

  5. Johnson & Johnson Pharmaceutical Research and Development, Titusville, NJ, USA

    Magali Haas

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  2. Jan Buitelaar
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Correspondence to Gahan J. Pandina.

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Supported by funding from Janssen, L.P.

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Jensen, P.S., Buitelaar, J., Pandina, G.J. et al. Management of psychiatric disorders in children and adolescents with atypical antipsychotics. Eur Child Adolesc Psychiatry 16, 104–120 (2007). https://doi.org/10.1007/s00787-006-0580-1

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